Provider Demographics
NPI:1003362955
Name:SHEN AND BUSQUETS DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:SHEN AND BUSQUETS DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSQUETS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,MS,CAGS
Authorized Official - Phone:510-538-2566
Mailing Address - Street 1:20600 LAKE CHABOT RD
Mailing Address - Street 2:STE 205
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5432
Mailing Address - Country:US
Mailing Address - Phone:510-538-2566
Mailing Address - Fax:
Practice Address - Street 1:20600 LAKE CHABOT RD
Practice Address - Street 2:STE 205
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5432
Practice Address - Country:US
Practice Address - Phone:510-538-2566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty